The effects of transfusion load on renal function in intraoperative salvage autotransfusion: a retrospective cohort...

This study aimed to investigate the effect of transfusion load on renal function during intraoperative salvage auto-transfusion.

A total of 200 patients were assigned to five groups based on the transfusion load: 0-200 mL (Group A, n = 40), 201-400 mL (Group B, n = 40), 401-600 mL (Group C, n = 40), 601-800 mL (Group D, n = 40), >800 mL (Group E, n = 40). Serum creatinine (sCr) and free hemoglobin (FHb) concentrations were measured at preoperative baseline (T₀), 1 h (T₃), 2 h (T₄), 12 h (T₅), and 24 h (T₆) post-auto-transfusion. FHb and sCr levels were also assessed in the blood storage tank before washed (T₁) and in the reinfusion bag after washing (T₂).

In Groups A, B, and C, there was no significant change in sCr levels between T0 and subsequent time points (T₃, T₄, T₅, T₆). However, in Groups D and E, sCr levels increased by more than 26.5 μmol/L from baseline at T₃ and T₄, with sustained elevations at T₃, T₄, and T₅ compared to T0. FHb concentrations were higher in both T₁ and T₂ compared to T₀, following a similar trend as sCr. Patients receiving more than 600 mL of autologous transfusion showed a transient increase in sCr at 1 and 2 h post-transfusion, consistent with acute kidney injury (AKI), which resolved by 24 h after transfusion.

Attention should be paid to renal function in patients receiving large volumes (>600 mL) of salvaged blood during intraoperative auto-transfusion, as these patients may experience transient AKI, which resolves over time.